Ovarian pain: 7 possible causes (and what to do?)

Many women these days have pain in their lower abdomen mainly in the right and left lower quadrants called iliac fossa. THE ovary are the organs that can be affected in this case. It is essential to talk about pain in the ovaries because they are essential organs for reproduction. Any damage to the ovaries must be adequately treated before it is too late.

This article sheds some light on ovarian pain. What are the various associated symptoms confirming that this pain is of ovarian origin? What are the different possible causes of ovarian pain? What attitude should you have as a woman in front of pain in the ovaries? What are the means of dealing with these causes?

What are ovaries? (left or right ovary pain, meaning)

The ovaries are the main reproductive organs in women called female gonads. Their equivalents in humans are the testicles. They are therefore 2 in number located on either side of the uterus. Almond-shaped, they are located near the fallopian tubes.

Their role is to produce eggs from puberty until menopause. They contain around 400 thousand follicles. In their normal functioning, at each cycle, one of the 2 ovaries brings a follicle to maturity. The latter will release an egg which will be captured by the fallopian tube via its widened end called the pavilion. It is inside this fallopian tube that the egg (female gamete) will be fertilized by the sperm (male gamete) following sexual intercourse, and later form the fetus.

If the egg is not fertilized, it dies and disperses. The follicle which has just ovulated turns into a structure called the corpus luteum which regresses until the end of the cycle and then disappears.

Another role also of the ovaries is to produce female sex hormones such as progesterone and estrogen. These hormones coordinate the female menstrual cycle, ovulation and menstruation.

How to recognize pain in the ovaries?

Ovarian pain is a feeling of discomfort in the right or left iliac fossa depending on the affected side. Typically, it is manifested by a burning sensation in the lower abdomen because it can radiate into the small pelvis (lower abdomen). It is sometimes referred to as an ovarian pinch, although a literal pinch does not occur. Similarities with pain of abdominal origin is possible.

You can also confuse pain in the ovaries with pain in the uterus, bladder and appendix (if the pain is located on the right side). Moreover, a pathology of the ovary is essential to rule out in women when appendicitis is suspected.

7 possible causes of ovarian pain

1- Painful ovulation

THEovulation is the mechanism by which the mature egg is expelled from the ovary. The timing of ovulation varies with each woman's menstrual cycle. In all cases it occurs 14 days before the first day of the next period.

During this process some women experience pain hence the term painful ovulation. The pain is unilateral right or left depending on the ovary activated.

The origin of this pain has not been concretely determined, however hypotheses have been made:

• The follicle which increases in volume just before the phenomenon of ovulation would exert pressure on the wall of the ovary and thus would cause the sensation of pain
• Blood or fluid released from the ruptured follicle could irritate the lining of the abdomen.

2- Ovarian cyst

Ovarian pain may be from an ovarian cyst. The larger the cyst, the more intense the pain. Indeed it will press on the viscera located around the ovary. The woman will then feel a kind of heaviness on the side of the ovary concerned.

There are two types of ovarian cyst: functional ovarian cyst which results from a malfunction of the ovary and the organic ovarian cyst which forms from the tissue of the ovary itself.

With regard to the functional cyst, it sometimes happens that a follicle once it has reached maturity does not expel its egg and continues to grow until it reaches 5 cm in diameter. In other cases, the corpus luteum is maintained instead of regressing.

Organic ovarian cysts, formed from ovarian tissue, are mostly benign. These are cysts serous (containing liquid), mucinous (containing mucus), dermoids (may contain hair, teeth, etc.) and endometriosis (related to endometriosis).

3- Ovarian cancer

Ovarian cancer, although uncommon, is a possible cause of ovarian pain. It occurs when there is an abnormality in the multiplication of cells in the ovary.

These transform and multiply in an anarchic way, forming a malignant tumor. Ovarian cancer can be classified into 4 stages according to its evolution:

• Stand 1: the cancer is limited to the ovaries.
• Stand 2: the tumor has spread locally to the organs of the pelvis (pelvic organs: the uterus, the fallopian tubes, the bladder, etc.).
• Stand 3: the tumor has spread to the peritoneum or the lymph nodes located in the pelvis (pelvic nodes). We are talking about regional metastases.
• Stand 4: the cancer has spread to distant organs: the pleura (envelope of the lungs), the liver, etc. in the form of distant metastases.

4- Ectopic pregnancy

An ectopic pregnancy (EUG) is caused by the implantation and development of the egg outside the uterus instead of taking place in the uterine cavity. In the majority of cases (95%), the egg implants in the fallopian tube and will therefore cause ovarian-type pain associated with several other symptoms such as:

• Light bleeding
• Dizziness
• Fever
• The rupture of the tube where the egg has settled

5- Infection

Ovarian pain can also be of infectious origin. It can occur as a result of an ovarian abscess, a salpingitis (infection of the fallopian tube), after a sexually transmitted infection (STI), the installation of an IUD or following the practice of an endo-uterine examination.

Furthermore, an infection of a neighboring organ such as theappendix can trigger pain in the ovarian area.

6- Polycystic ovary syndrome (PCOS)

It is a pathology affecting women of childbearing age during which the ovaries increase in size due to the presence of multiple small cysts. These cysts are actually small follicles that are not mature enough to ovulate.

PCOS is due to excessive production of androgen (one of the male hormones) which disrupts the proper functioning of follicles and ovaries. Women with this syndrome not only feel pain in their ovaries but also have very irregular cycles, even a total absence of ovulation.

7- Endometriosis

Ovarian pain may be due to a problem withendometriosis. Endometriosis is a disease characterized by the proliferation of cells from the endometrium (inner layer of the uterus) outside of it. We will then find fragments of endometrium on the ovaries for example but also in the fallopian tubes, the bladder, the abdomen.

At the time of menstruation, the cells will detach and cause an inflammatory reaction, responsible for severe pain. We must therefore think of endometriosis in a woman who complains of pain in the ovaries on the approach and during menstruation.

What to do in the face of pain in the ovaries?

“I have pain in my right (or left) ovary” is a phrase you sometimes hear women having pain in this region.

A woman who experiences persistent or recurrent pain in the ovaries should imperatively consult a general practitioner or a gynecologist. The specialist will carry out a complete clinical examination and a methodical examination in order to establish diagnostic hypotheses. He may therefore request additional tests to confirm his diagnosis.

THEPelvic ultrasound is the examination that will explore the condition of the ovaries and other organs of the female reproductive system. She will check for the presence or absence of endometriosis.

If she finds an abscess or an ovarian cyst, she will determine its size. It also allows to see if there is an intra pelvic hemorrhage related to an extra uterine pregnancy or a fluid effusion due to an infection.

If no clue was seen on the ultrasound, the doctor may prescribe biological tests to look for infection, in particular the vaginal swab.

Treatment of causes

In the case of an ovarian cyst, ultrasound monitoring should be done when it is functional. However, one can consider an operation:

• if the cyst persists for more than 3 menstrual cycles
• if his appearance changes
• if unbearable pain occurs.

If it is an organic cyst, the removal of the cyst or the ovary can be performed. It should be noted that surgery should be avoided as much as possible in young women who have not yet procreated. But the surgery is usually the only option for the ovarian cancer to save the patient's life.

For the management of EP, it is often necessary to remove the affected fallopian tube during surgery. The treatment of pelvic infections will go through taking medication antibiotics. The management of PCOS will go through drug treatment to correct the hormonal imbalance and regulate the menstrual cycle.

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat various body pains, especially for their anti-inflammatory power.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation:

• Turmeric : Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.

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• Ginger : In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. THE gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).

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• Omega-3s : Omega-3 are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 

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• Lemon eucalyptus: Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.

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• wintergreen : Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

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References

1. https://www.qare.fr/sante/douleur-ovaire/#:~:text=Chez%20la%20femme%2C%20il%20est,la%20m%C3%AAme%20p%C3%A9riode%20chaque%20mois.
2. https://sante.journaldesfemmes.fr/fiches-sexo-gyneco/2690131-mal-aux-ovaires-douleur-cause-regles-ovulation-rapport-grossesse-gauche-droite/
3. https://curie.fr/dossier-pedagogique/les-ovaires-comment-ca-marche#:~:text=Les%20ovaires%2C%20ce%20sont%20les,contiennent%20environ%20400%20000%20follicules.
4. https://sante.journaldesfemmes.fr/fiches-maladies/2476672-kyste-ovarien-cause-douleur-symptomes-operation/